Carcinoma of the Prostate Flashcards
What are 3 risk factors for Prostate Cancer?
- Age
- Family history (Associated with BRACA2 mutation)
- Ethnicity (Black>White>Asian)
What are the 4 zones of the Prostate?
- Anterior
- Transitional
- Central
- Peripheral
In what zone are most Prostate cancers found?
Peripheral zone (Hence easier to feel on a rectal examination)
Increasingly, prostate carcinoma is found after investigation of elevated PSA (prostate specific antigen)
Does a normal PSA rule out prostatic cancer?
List 5 causes of elevated PSA
No
- Prostate cancer
- Inflammation
- Infection (elevated for up to 6 weeks after)
- Large prostate
- Urinary incontinence
How does prostate cancer present?
Opportunistic screening is done, but not mass population
- Urinary symptoms
- Bone pain (Can metastasise)
- Raised PSA
- Incidental finding from a rectal examination
What is the Gleason classification used for?
Used for grading of tumours based on histological appearance
How can Prostate Cancer be diagnosed?
- Rectal exam: Hard, irregular prostate
- USS: To define a prostatic mass
- PSA level: Raised (Normal doesn’t rule out)
- Biopsy
- Radiographs and bone scans
In advanced Prostatic cancer, what may you see on a Radiograph or bone scan?
Radiograph;
- Sclerotic lesions
Bone scan;
- ‘Hot spots’ of increased isotope uptake
How can localised prostate cancer be treated?
- Surgery
- Hormone therapy
- Radiotherapy
How can advanced prostate cancer be treated?
- Palliative care
- Hormonal manipulation (Testosterone/ Dihydrotestosterone promote tumour growth)
- Surgical castration
- Medical castration (LHRH, GnRH Agonists)
5 year survival for T1 prostate cancer is 75-90%.
What does this drop to if there is local/ metastatic spread?
30-45%
On a rectal exam, the prostate can normally be felt as 2 lobes jointing in the midline (The median Sulcus).
What does it mean if this median sulcus can’t be felt?
Signifies presence of a growth/ mass of the prostate
